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Overview: Erlotinib is used to treat certain cancers. Common side effects include rashes, diarrhea, and loss of appetite. Call your health care provider right away if you get a fever, changes in your vision, new or worsening shortness of breath, or severe diarrhea or rash. Get emergency help if you get severe stomach pain, a severe headache, trouble breathing, trouble speaking, blisters inside your mouth, or blistering or peeling of your skin.

Uses

What is erlotinib used for?

Erlotinib is commonly used to treat certain kinds of the following cancers. 

Erlotinib may also be used for other conditions as determined by your health care provider.

How does erlotinib work (mechanism of action)?

Erlotinib is a type of medicine known as a tyrosine kinase inhibitor. It works by targeting specific proteins on cancer cells. By blocking the action of these proteins, erlotinib can cause cancer cells to die and can prevent cancer cells from growing or spreading.

How is erlotinib supplied (dosage forms)?

Brands and other names

  • Tarceva

Dosage forms and strengths

  • 25 mg, 100 mg, 150 mg oral tablets

How should I store erlotinib?

Erlotinib should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when you’re transporting it. Store it in a cool, dry place.

Side Effects

What are the most common side effects of erlotinib?

The most common side effects of erlotinib are listed below. Tell your health care provider if you have any of these side effects that bother you. Side effects may differ based on the condition you are using erlotinib to treat.

  • Rash
  • Diarrhea
  • Loss of appetite
  • Tiredness
  • Shortness of breath
  • Cough
  • Nausea and vomiting

There may be other side effects of erlotinib that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of erlotinib?

While less common, the most serious side effects of erlotinib are described below, along with what to do if they happen.

Severe Allergic Reactions. Erlotinib may cause allergic reactions, which can be serious. Stop taking erlotinib and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Lung Inflammation. Erlotinib can cause inflammation in your lungs, also called interstitial lung disease or pneumonitis. This can be serious or even life-threatening. Get emergency help if you have new or worsening trouble breathing. You may also have a cough, fever, or chest pain. 

Kidney Damage. Kidney damage can happen when taking erlotinib. Call your health care provider right away if you have any of the following symptoms of kidney damage.

  • Reduced need to pee
  • Swelling in your feet, ankles, or legs
  • Weakness or unusual tiredness
  • A hard time catching your breath or chest pain/pressure
  • Confusion
  • Nausea
  • Seizures

Liver Damage. Liver damage, also called hepatotoxicity, can happen when taking erlotinib. Keep all appointments to have your blood checked. Call your health care provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored urine (pee)
  • Your skin or the whites of your eyes turning yellowish in color (also called jaundice)

Stomach Bleeding. Erlotinib can increase your risk of tears (perforation) in your gut. Stop taking erlotinib and get emergency help if you have any of the following symptoms.

  • Vomit blood
  • Black or tarry poop
  • Stomach pain that does not go away
  • Upset stomach
  • Feel faint

Severe Skin Reactions. Erlotinib can cause severe skin reactions, called Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), as well as blistering and peeling of your skin that can lead to death if not treated. If you develop a severe rash, call your health care provider right away. Get emergency help if you have any of the following symptoms of SJS or TEN.

  • Painful red or purple skin that looks burned and peels off
  • Flat red rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes
  • Flu-like symptoms including a fever, chills, and muscle aches

Stroke. Erlotinib can increase your risk of a stroke that can lead to death. Get emergency help if you have any of the following symptoms of a stroke.

  • Sudden numbness or weakness on one side of your body
  • Vision changes in one or both eyes, or trouble swallowing
  • Sudden and severe headache
  • Problems with dizziness, walking, or balance
  • Slurred speech or trouble understanding speech

Blood Disorders. Erlotinib can cause hemolytic anemia with low platelet levels (thrombocytopenia). Call your health care provider right away if you have any of the following symptoms.

  • Fever
  • Shortness of breath
  • Pale or yellowish skin
  • Easy bruising or bleeding
  • Frequent infection
  • Unusual weakness or tiredness
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Headache
  • Fast or abnormal heartbeat

Severe Eye Problems. Erlotinib may cause eye problems, such as inflammation of the cornea (keratitis) and abnormal eyelash growth. Contact your health care provider right away if you have any of the following symptoms.

  • Eye redness, itchiness, or pain
  • Swollen or itchy eyelids
  • Feeling like you have something in your eye
  • Eye dryness, watering, or discharge
  • Vision changes, such as blurry vision or sensitivity to light

Warnings & Precautions

Who should not use erlotinib?

Allergies to Ingredients. People who are allergic to any of the following should not take erlotinib.

  • Erlotinib
  • Tarceva
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific erlotinib products they stock.

What should I know about erlotinib before using it?

Do not take erlotinib unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share erlotinib with other people, even if they have the same condition as you. It may harm them.

Keep erlotinib out of the reach of children.

Take erlotinib on an empty stomach and at least one hour before a meal or two hours after a meal.

Your health care provider will have you do regular blood tests before taking and while taking erlotinib. Make sure to go to all appointments so they can make sure that erlotinib is safe for you.

Erlotinib can make your skin more sensitive to light from the sun, sunlamps, and tanning beds. This is called photosensitivity. Exposure to this light can cause severe sunburns, blisters, and swelling. If you need to be in sunlight, wear sunscreen, a hat, and clothing that covers your skin.

You should not smoke cigarettes while taking erlotinib. If you decide to start or stop smoking cigarettes while taking erlotinib, talk with your health care provider. It is possible that your erlotinib dose will need to be adjusted. 

Erlotinib may make your nails loose and brittle while you are taking the medicine. It may also cause an increase in hair growth. Talk with your health care provider if these are concerns for you. 

What should I tell my health care provider before using erlotinib?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if erlotinib is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Eye problems
  • Previous stroke, bleeding, or blood clot problems
  • Stomach or digestion problems, such as a previous ulcer, tear in your stomach or intestine, or any type of inflammation of your intestines
  • Liver problems
  • Kidney problems

Other Medicines and Supplements. Erlotinib may interact with other medicines and supplements. Before taking erlotinib , tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Erlotinib may harm an unborn baby. Your health care provider may give you a test to make sure you are not pregnant before you start taking erlotinib. If you can get pregnant, you should use birth control while taking erlotinib and for one month after your last dose. Tell your health care provider right away if you are pregnant, think you may be pregnant, or plan to become pregnant.

Breastfeeding. It is not known if erlotinib passes into breast milk. You should not breastfeed while taking erlotinib and for two weeks after your last dose. Tell your health care provider if you are breastfeeding or plan to breastfeed.

Interactions

Does erlotinib interact with foods or drinks?

Erlotinib should be taken on an empty stomach and at least one hour before a meal or two hours after a meal.

Grapefruit interacts with erlotinib. It is important to avoid eating grapefruit or drinking grapefruit juice while taking erlotinib. This is because grapefruit can interfere with your body’s ability to break down erlotinib, which can lead to high levels of the medicine and a higher risk of side effects. 

It is unknown if drinking alcohol will affect erlotinib, but heavy drinking can slow your immune response and make it harder for your body to fight cancer.

Does erlotinib interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking erlotinib.

  • Warfarin, which is a blood thinner
  • St. John’s wort, which is a supplement that may be used for depression
  • A medicine for HIV, AIDS, or hepatitis C
  • Clarithromycin or ciprofloxacin, which is a medicine used for bacterial infections
  • Ketoconazole, itraconazole (Sporanox, Tolsura), or posaconazole (Noxafil), which is a medicine used for fungal infections
  • Nefazodone, which is a medicine used to treat depression
  • Carbamazepine (Carbatrol, Tegretol, and others), which is a medicine commonly used to treat seizures or nerve pain
  • Phenytoin (Dilantin, Phenytek, and others), which is a medicine to control seizures
  • Phenobarbital, which is a medicine that may be used to treat seizures
  • Rifampin (Rifadin) or rifapentine (Priftin), which is a medicine commonly used to treat an infection called tuberculosis
  • Rifabutin (Mycobutin), which is a medicine used to prevent mycobacterium avium complex infection
  • A proton pump inhibitor (PPI), such as esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), or rabeprazole (Aciphex)
  • An H2 blocker, such as cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid), or ranitidine (Zantac).
  • An antacid containing calcium, aluminum, magnesium, or iron

Many other medicines may alter the blood levels of erlotinib. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with erlotinib. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much erlotinib?

If you or someone else has used too much erlotinib, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of erlotinib?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.

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